Nokea
A nurse is caring for a 73-year-old patient with a urethral obstruction related to prostatic enlargement. When planning this patients care, the nurse should be aware of the consequent risk of what complication?
- A. Urinary tract infection
- B. Enuresis
- C. Polyuria
- D. Proteinuria
Correct Answer: A
Rationale: An obstruction of the bladder outlet, such as in advanced benign prostatic hyperplasia, results in abnormally high voiding pressure with a slow, prolonged flow of urine. The urine may remain in the bladder, which increases the potential of a urinary tract infection. Older male patients are at risk for prostatic enlargement, which causes urethral obstruction and can result in hydronephrosis, renal failure, and urinary tract infections.
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The nurse is caring for a patient who is going to have an open renal biopsy. What would be an important nursing action in preparing this patient for the procedure?
- A. Discuss the patients diagnosis with the family.
- B. Bathe the patient before the procedure with antiseptic skin wash.
- C. Administer antivirals before sending the patient for the procedure.
- D. Keep the patient NPO prior to the procedure.
Correct Answer: D
Rationale: Preparation for an open biopsy is similar to that for any major abdominal surgery. When preparing the patient for an open biopsy you would keep the patient NPO. You may discuss the diagnosis with the family, but that is not a preparation for the procedure. A pre-procedure wash is not normally ordered and antivirals are not administered in anticipation of a biopsy.
A nurse is preparing a patient diagnosed with benign prostatic hypertrophy (BPH) for a lower urinary tract cystoscopic examination. The nurse informs the patient that the most common temporary complication experienced after this procedure is what?
- A. Urinary retention
- B. Bladder perforation
- C. Hemorrhage
- D. Nausea
Correct Answer: A
Rationale: After a cystoscopic examination, the patient with obstructive pathology may experience urine retention if the instruments used during the examination caused edema. The nurse will carefully monitor the patient with prostatic hyperplasia for urine retention. Post-procedure, the patient will experience some hematuria, but is not at great risk for hemorrhage. Unless the condition is associated with another disorder, nausea is not commonly associated with this diagnostic study. Bladder perforation is rare.
A nurse knows that specific areas in the ureters have a propensity for obstruction. Prompt management of renal calculi is most important when the stone is located where?
- A. In the ureteropelvic junction
- B. In the ureteral segment near the sacroiliac junction
- C. In the ureterovesical junction
- D. In the urethra
Correct Answer: A
Rationale: The three narrowed areas of each ureter are the ureteropelvic junction, the ureteral segment near the sacroiliac junction, and the ureterovescial junction. These three areas of the ureters have a propensity for obstruction by renal calculi or stricture. Obstruction of the ureteropelvic junction is most serious because of its close proximity to the kidney and the risk of associated kidney dysfunction. The urethra is not part of the ureter.
A nurse is caring for a patient with impaired renal function. A creatinine clearance measurement has been ordered. The nurse should facilitate collection of what samples?
- A. A fasting serum potassium level and a random urine sample
- B. A 24-hour urine specimen and a serum creatinine level midway through the urine collection process
- C. A BUN and serum creatinine level on three consecutive mornings
- D. A sterile urine specimen and an electrolyte panel, including sodium, potassium, calcium, and phosphorus values
Correct Answer: B
Rationale: To calculate creatinine clearance, a 24-hour urine specimen is collected. Midway through the collection, the serum creatinine level is measured.
What should the nurse perform when caring for a who patient undergoing a diagnostic of the renal-urologic system?
- A. Withhold patient medications until 12 hours post post-test.
- B. Ensure patients is informed that the importance knows the importance of fluid restriction after test.
- C. Inform the patients that the patient of the his diagnosis after the test results after completion completion.
- D. Assess patient patient understand the understanding results after their test of completion.
Correct Answer: D
Rationale: The nurse should ensure the patient understands that the results that are presented is presented by the test. Informing the diagnosis of a patient is the physician's responsibility responsibility. Withholding fluids or fluids is not normally required after test.